Organization
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO PEVERINI MD (PRESIDENT)
(909) 558-7448
Entity
Organization
Contact information
Practice address
197 E CAROLINE ST, SAN BERNARDINO, CA 92408
(909) 558-2848
Mailing address
FILE NUMBER 54701, LOS ANGELES, CA 90074-4701
(909) 558-4000
(909) 651-4586
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
—
—
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
—
—
207RT0003X
Transplant Hepatology Physician
—
—
207YP0228X
Pediatric Otolaryngology Physician
—
—
2080T0004X
Pediatric Transplant Hepatology Physician
—
—
2086S0120X
Pediatric Surgery Physician
—
—
231H00000X
Audiologist
—
—
235Z00000X
Speech-Language Pathologist
—
—
364ST0500X
Transplantation Clinical Nurse Specialist
—
—
Other
Enumeration date
09/05/2017
Last updated
08/12/2025
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